Recent advances in materials surface processing and our understanding of cell-surface interactions have led to development of a unique surface (Laser-Lok) that has been shown to firmly attach bone, fibrous connective tissue, and epithelium. This surface comprises the first controlled microstructure surface in clinical use and is produced using high-precision laser technology. It consists entirely of small microchannels, 8 or 12 ?m in size and depth, with superimposed micro- and nanostructure produced by the laser micromachining. The microchannels have been shown to control the organization, proliferation, and differentiation of cells at the tissue-implant interface. The most unusual aspect of this surface is its ability to firmly attach collagenous fibrous tissue. This allows it to be used on the collars and abutments of dental implants to encourage formation of a soft tissue seal, which prevents deep sulcus formation and crestal bone loss. This presentation will concentrate on the current state of knowledge of how fibrous tissue forms at implant surfaces, how this occurs adjacent to most surfaces, and how the Laser-Lok surface modifies this process. The impact of fibrous tissue attachment and its effects on adjacent epithelium and bone will be discussed, as well as how this, along with implant and abutment surfaces and designs, determines the level and configuration of bone, fibrous tissue, and epithelium around implants. The clinical significance of these tissue levels on esthetics will also be discussed.
John L. Ricci, PhD, received his PhD from the University of Medicine and Dentistry of New Jersey. He is currently an associate professor in the Department of Biomaterials and Biomimetics at New York University College of Dentistry, where he directs the Masters Program in Biomaterials Science. Dr Ricci is an active member of the Society for Biomaterials, the American and International Associations of Dental Research, and the Academy of Osseointegration. He is also on the editorial boards of the Journal of Biomedical Materials Research: Applied Biomaterials and Implant Dentistry. His active areas of research involve cell and tissue response to permanent and resorbable biomaterials and the development of implants, bone graft substitutes, and tissue-engineered devices.
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